Clinical Meditation

Dr. Ruwan M Jayatunge 

Clinical Meditation is a new form of therapy that can be used to treat a large number of physical / psychological / psychiatric ailments. For centuries meditation was considered as a type of religious practice forgetting its clinical aspect. A large body of research highlights the clinical value of meditation. Meditation enhances neuron connectivity in the brain positively changing the brain chemistry. Meditation experience changes the brain structures predominantly increasing the cortical thickness and cerebral blood flow. 

Meditation has many health benefits. Meditation balances the body's homeostatic system.  Meditation can be used to treat anxiety disorders and depression.  Meditation is a great stress breaker . The meditation practice helps to decrease stress hormones in the body. Meditative techniques are indicated in chronic pain. Meditation strengthens the immune system. It facilitates positive emotions enhancing memory and attention. Meditation brings beneficial changes to physical and mental health and it can be used for overall wellness. However meditation remains an under-utilized therapeutic mode in the medical profession.

Meditation Overview

The word “meditation” is derived from the Latin meditari, which means “to engage in contemplation or reflection (Hussain & Bhushan, 2010). Meditation has been extensively practiced in many civilizations for thousands of years as a means of cultivating a state of well-being and for religious purposes (Braboszcz et al., 2010). Meditation has a number of definitions.

The U.S. National Center for Complementary and Alternative Medicine (NCCAM) defined meditation as “a conscious mental process that induces a set of integrated physiological changes termed the relaxation response”. According to Manocha (2000) meditation is a discrete and well-defined experience of a state of “thoughtless awareness” or mental silence, in which the activity of the mind is minimized without reducing the level of alertness. 

According to  Walsh and Shapiro (2006) meditation is a “tool” for spiritual development, where the aim is to reach an inner peace, concentration, positive emotions, while at the same time reducing stress, agitation and negative emotions. 

Clinical meditation is a secular psychotherapeutic application that is geared to achieve optimal mental wellbeing.  Clinical meditation helps to combat various psychological / psychiatric ailments such as irresistible stress, severe anxiety, depression, chronic pain and addictions. Meditation is one of the effective psycho- behavioral therapies. It is becoming widely popular as an adjunct to conventional medical therapies (Bonadonna, 2003).

The Clinical Effects of Meditation

Meditation practices are connected with the psychotherapeutic approaches creating a holistic impact. Clinical meditation may mitigate the effects of stress and disease. Clinical application of meditation is indicated in a number of ailments. Meditation is a safe and cost-effective treatment mode which brings effective results. It is a scientifically proven intervention. Numerous researchers have found the    therapeutic benefits of meditation.  Today meditation has become an efficient psychotherapeutic technique in the Western world.

Clinical effects of meditation impact a broad spectrum of physical and psychological   symptoms and syndromes, including reduced anxiety, pain, and depression, enhanced mood and self-esteem, and decreased stress. Meditation has been studied in populations with fibromyalgia, cancer, hypertension, and psoriasis (Bonadonna, 2003). Meditation has become a dominant method for self-regulation. Jindal   Gupta and Das (2013) state that meditation causes improvement in various cardiovascular, neurological, autoimmune, and renal pathologies.

Reibel and colleagues (2001) indicate that mindfulness meditation training program can enhance functional status and well-being and reduce physical symptoms and psychological distress.  Meditation practice can positively influence the experience of chronic illness and can serve as a primary, secondary, and/or tertiary prevention strategy (Bonadonna, 2003). Meditation helps to cultivate positive mental health. Therefore meditation has an immense public health importance.

The Western Theories of Meditation

Although mindfulness meditation has been practiced in the East for more than two millennia, Western scientific research and healthcare programs have only recently drawn their attention to it (Manuello et al., 2016). The Eastern spiritual practice of meditation was brought to the West by various spiritual masters. Among these spiritual practitioners Maharishi Mahesh Yogi was a key figure. He developed the Transcendental Meditation technique and popularized meditation in the Western world. Even Beatles became the followers of Maharishi Mahesh Yogi.

Western theories of meditation include Jungian, Benson's relaxation response, and transpersonal psychology (Bonadonna, 2003). In the early 1970s  Dr Herbert Benson, -founder of the Mind/Body Medical Institute at Massachusetts General Hospital in Boston did a number of studies on meditation. Dr Herbert Benson considered meditation is an antidote to stress. Benson and colleagues (1974) surmised that meditation givesrelaxation response by decreasing sympathetic nervous system activity, and increasing parasympathetic activity.

The American Psychologist Robert Evan Ornstein who profoundly wrote about brain's role in health. According to Ornstein (1972) meditation exercises are designed to produce an alteration in consciousness, which means a shift away from an active, outward-oriented, linear mode towards receptive and quiescent mode with a shift from external focus of attention to an internal one. 

The Australian Professor of Psychiatry Roger N. Walsh states that more than an alternative state of consciousness meditation is associated with calmness, equanimity, concentration, compassion, wisdom, generosity, and perceptual and introspective sensitivity.  

Professor Jon Kabat-Zinn of the University of Massachusetts Medical School performed a number of research in mediation and found its clinical value.  Jon Kabat-Zinn studied the interaction of mind and body towards health. According to Kabat-Zinn meditation has impact on the entire organism–from chromosomes to cells and to brain.

The Buddhist meditation techniques profoundly influenced Jon Kabat-Zinn. However Kabat-Zinn introduced mediation to the clinical community as a secular model. His studies were mainly based on mindfulness meditation. For Kabat-Zinn mindfulness is being awake. He did clinical applications of mindfulness on people with chronic pain and stress-related disorders and found fruitful results.

In 1979 Mindfulness-Based Stress Reduction (MBSR) Program was introduced by the University of Massachusetts Medical Center. This program incorporated mindfulness and assisted people with pain and a range of conditions and life issues that were initially difficult to treat in a hospital setting.  Over the years (MBSR) Program gained immense popularity due to its success rate.  MBSR has been described as "a group program that focuses upon the progressive acquisition of mindful awareness, of mindfulness (Grossman et al., 2010).

B. Alan Wallace founder of the Santa Barbara Institute for Consciousness Studies describes meditation as cultivating mental balance. Wallace and Shapiro (2006) assume that mental suffering is in large part due to imbalances of the mind and that these imbalances can be overcome by cultivating four kinds of mental balance: conative, attentional, cognitive, and affective (Sedlmeier, 2012).

The Western science views meditation in a neuropsychological lens. Neuroimaging and neuropsychology of meditation states have been studied. According to these research meditation has a positive impact on cerebral cortex, prefrontal area, cingulate gyrus, neurotransmitters, white matter, autonomic nervous system, limbic system, cytokines, endorphins, hormones.

Researchers measured brain activation with functional magnetic resonance imaging (fMRI) in meditators and found   meditation activates the prefrontal cortex of the brain.  Prefrontal cortex is in charge of abstract thinking, thought analysis and responsible for regulating behavior. In addition prefrontal cortex involved in emotional responses. Prefrontal cortex is responsible for controlling neurotransmitters such as dopamine, norepinephrine, and serotonin that are important in mood regulation. Hölzel and the group found greater activation of rostral anterior cingulate cortex (ACC) and dorsal medial prefrontal cortex (MPFC) in mindfulness meditators.

Jensen and colleagues (2014) found increase of grey matter in the hippocampus (hippocampus- involved in memory formation, memory organization, and memory storing) and parietal lobe (   parietal lobe -processes sensory information) among the mindfulness meditators. Grey matter is a major component of the central nervous system, consisting of neuronal cell bodies, neuropil, glial cells, synapses, and capillaries. There is a strong connection between gray matter and intelligence, self-control and decision making.

Meditation produces positive alterations of neurotransmitters, brain activity, and cognitive abilities (Luders, 2014). Practice of meditation triggers neurotransmitters (Krishnakumar et al., 2015). According to Kang and colleagues (2013) long-term meditators have structural differences in both gray and white matter. Furthermore meditation diminishes age-related brain degeneration. Pagnoni and Cekic (2007) state that meditation may have neuroprotective effects and reduce the cognitive decline associated with normal aging.